Kynnera Stephenson, AGPCNP-BC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

AP61507659 Issued in WA

Practice address

401 Broadway Ste 100
Tacoma, WA 98402-3900

Phone

(253) 468-6524

NPI assigned

Dec 4, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Women'S Holistic Medical Weight Loss Clinic LLC

  • Family Nurse Practitioner
  • Tacoma, WA
  • NPI 1467107508
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1701648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1679349401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 BROADWAY STE 100",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984023900",
            "telephone_number": "253-468-6524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 BROADWAY STE 100",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984023900",
            "telephone_number": "253-468-6524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENSON",
        "first_name": "KYNNERA",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-04",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "WA",
            "license": "AP61507659",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WA",
            "license": "AP61507659",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP61507659",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juliane Pamela Stephens
• Leann Stephens, MSW
• Rishika Lagisetti Stephens
• Stevie Stephens, CP
• Ernest Stephen Stephenson, PA-C
• Natasha Sue Stephenson, LMP
• Ramona Stephenson
• Roberta Sue Stephenson, M.D.
• Katrina Lynn Sterling, ARNP
• Kimberly Ida Sterling, RDH

• Primary Care Nurse Practitioner in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Primary Care Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.